By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Editor’s note. This appeared in the December issue of National Right to Life News. Please share with your pro-life family and friends.
Though it might seem somewhat anticlimactic after some other national groups have released data on the number of abortions since Dobbs, the U.S. Centers for Disease Control (CDC) has kept to its own organizational schedule and issued its report on abortions that took place in America in 2021 the day after Thanksgiving.
In short, they say that the numbers of abortions and their frequency in the population have increased in the last five years CDC studied. While we know that big changes occurred in 2022 with the Supreme Court’s decision to overturn Roe, the CDC report gives us a good idea of where the industry was headed and how it was preparing for the road ahead.
Unlike Guttmacher and the Society for Family Planning, who rely directly on abortion “providers” for their numbers, the CDC develops its reports from the voluntary submissions of state health departments. Not every state reports the same data, and some states do not report at all, but CDC abortion surveillance reports have the advantage of using a standard format and reporting every year, making trends apparent and helping make year-to-year comparisons possible.
In its 2021 “Abortion Surveillance,” the CDC found the number of abortions rising by more than 5,000 from the previous year and saw abortion rates and ratios return to levels not seen in five years or more.
The CDC reported 625,978 for 2021, after reporting 620,327 the year before. The latest figure does not include any abortions from New Jersey, which reported nearly 23,000 abortions in the previous report. But as we have reported about with previous CDC studies, though good for comparisons, this still does not reflect the full national total, thought to be somewhere between 900,000 and a million, since the CDC has not had any data from California, Maryland, or New Hampshire in any of its report since 1998.
Even with these higher numbers, we are clearly better off than we were in the 1980s and 1990s, when abortions hovered between 1.5 and 1.6 million a year before finally beginning a long drop off that now seems to have continued through 2017.
But recently, with these latest figures, abortions appear to have been on the increase.
The abortion rate, which for the CDC measures the frequency of abortion, hit 11.6 per thousand women of reproductive age (15-44). That is higher than it has been any year since 2015, when it hit 11.8.
The abortion ratio, by which the CDC contrasts the number of abortions for every thousand live births, hit 204 in 2021. It had not been above 200 since 2012 when it was 207.
Increases were seen pretty much across the board, with higher numbers of abortions being reported in 33 reporting areas (32 states and New York City) and decreases (some very small) found in just 15 reporting areas (14 states and Washington, DC).
Though the trend is broadly up, each state has its own story. For example, high percentages of those obtaining abortions in Washington, DC (70.8%), Kansas (49.9%), New Mexico (40.3) and Oklahoma (39.6%) came from another state. In the case of New Mexico and Oklahoma, it is clear that a large number came from Texas, which had just put some excellent protective legislation in place. An abortion clinic just across the border in Kansas picked up a lot of traffic from Missouri, which had just seen its last abortion clinic close in a legal dispute over licensing.
Age and Race
Over the past ten years, the CDC actually shows abortion numbers, rates, and ratios dropping for most age groups, 15-19, 20-24, 25-29, and 40 and up. For some reason, however, abortion numbers and rates increased for women 30-34.
Abortion ratios also fell for that group, though, and rates and ratios also fell for women ages 35-39, even though the raw number of abortions increased.
Though reasons are unclear and the changes are generally small, this means that these recent increases are concentrated in that middle range of women in their 30s.
Abortions and racial minorities
The CDC found that abortion rates for black women (28.6) were more than four times that of white women (6.4). The black abortion ratio was also higher by the same fourfold factor (498 to 116).
Hispanic abortion rates were also higher, though not as extreme. Abortion rates for Hispanics (12.3) were nearly twice that of white women, and the Hispanic abortion ratio was just over one and a half times higher (186).
Racial and ethnic figures should be taken with a grain of salt, however. Many states known to have higher minority populations (New York state, Illinois, Louisiana, Ohio, Pennsylvania, etc.) do not report this data to the CDC or did not report any data to the CDC at all (California, Maryland, New Jersey).
Marital Status and Previous Pregnancies
As it has been the case most of recent history, the vast majority of abortion (87.3%) are to unmarried women.
Statistics also continue to show that most women (60.7%) having abortions have already given birth to at least one child. Many women (43.7%) report having had at least one previous abortion, while 7.7% reported having had three or more past abortions.
Gestational Age and Abortion Method
More than nine out of every ten abortions are performed in the first trimester. Just 6.6% of abortions are performed at 14 weeks or more and less than one in a hundred (0.9%) occurred at 21 weeks gestation or more.
An increasing number of abortions are happening very early in pregnancy. The CDC says that 44.8% of abortions occurred at six weeks or less.
A large part of this surge in early abortions comes from two sources. The first is the development of the early surgical technique called MVA or manual vacuum aspiration. That accounted for nearly three out of every ten abortions that occurred at six weeks or less.
Chemical or “medication” abortions account for the other 70.6%. Largely thanks to chemical abortions, more than half (54%) of the abortions the CDC tracked for gestational age happened at nine weeks or less.
The CDC records that 56% of all abortions are now chemical abortions.
Various studies have shown that government agencies miss a lot of abortion related complications and maternal deaths, but it is remarkable nonetheless that the CDC continues to find and report instances of women dying from abortion.
Figures are always a year behind, but the CDC reports that six women died from legal abortions in 2020. This is important to keep in mind amidst constant assertions of chemical and surgical abortion safety.
Value of 2021 data today?
It is legitimate to ask what value 2021 data has in this new post-Dobbs environment. One thing this data helps the concerned pro-lifer see is how the abortion industry has long been preparing for Roe’s demise.
Early chemical abortions ascendant
The shift to chemical abortions was more than just the introduction of a new product. It was part of a strategic effort to make the provision of abortion less dependent on brick and mortar abortion clinics and abortionists with surgical training.
While, at least in theory, one needed a trained surgeon, full operating equipment, trained assistants, waiting and recovery rooms to offer even standard suction aspiration abortions, anyone, it was argued, could dispense pills.
Chemical abortions also enabled the move towards earlier, supposedly less controversial abortions. Most of these are chemical. As seen above, more and more abortions are performed at nine, or even six weeks or less.
Though the humanity of these children is scientifically beyond question, their size and development make these an easier sell to the public and to women distressed by the discovery of their pregnancy.
Sponsored abortion tourism
Look into the details of this report and previous ones and one can see that many abortion patients have “migrated” from one state to another.
Missouri’s abortions dropped to less than a hundred while Kansas saw nearly half of its abortion patients coming from other states. New Mexico and Oklahoma abortion clinics saw lots of out of state traffic when protections for unborn children went into effect in Texas.
This is not random consumer traffic. Clinic employees in Texas specifically helped arrange for and in many cases funded the travel of abortion patients to clinics in other states.
Abortion friendly states have advertised for abortion tourism.
Abortion giants like Planned Parenthood have set up mobile clinics and built giant mega-clinics just across state lines to pick up customers from nearby states which have protections in place for unborn children and their mothers.
Chemical abortions by mail, recently authorized by the Biden administration, also enable unscrupulous abortion pill promoters to ship their deadly pills into states where they might not be legal. There is some concern that these will be difficult to count and monitor.
Strands of all these elements can be found in the CDC’s 2021 Abortion Surveillance.
Improved, but not done
We’ve clearly made a lot of progress since the 1990s when abortion peaked at 1.6 million a year and we’re obviously a lot better off with Roe now on the ash heap of history. But numbers like this show us that the abortion industry has been preparing for this day and has been hunkering down for the long term.
We’re certainly in a better situation today than we were in 2021, but we still have a long way to go.